Topics in Geriatrics: Geriatric Depression Scale: Short Form
The Geriatric Depression Scale: Short Form is designed to identify older adults who may be at risk for becoming depressed1. Depression is prevalent in 8-16% of community dwelling older adults and even more common among those in long term care facilities2 (Blazer, 2009). Depression is often overlooked in older adults or simply attributed to other issues associated with aging. Depression is not a normal part of aging and should be screened for by all healthcare professionals. Signs of depression in senior citizens may include but are not limited to feeling tired, empty, altered appetite, unexplained pain, loss of interest in activities, altered sleep cycles, anxiousness and irritability1. As PTs we will consistently have direct contact with older adults in long term care facilities on a more regular basis than many other professionals. The application of the GDS:SF is simple, quick and can have a dramatic impact if it is appropriately implemented and followed up.
Learning Objectives: 1) Understand the basis for using the Geriatric Depression Scale Short Form 2) Learn to implement and score the GDS-SF. 3) Determine appropriate and inappropriate populations for using the GDS-SF. 4) Understand what to do with the results of the screening
Basics of the scale Geriatric Depression Scale: Short Form The short version of the Geriatric Depression Scale is a 15 question measure of depression risk in senior citizens. Items are simple yes/no questions that can be filled out with the patient in under 10 minutes 3. The questions that comprise the short form were selected from the original 30 item GDS based upon their validity and correlation with a diagnosis of depression4. Application of the screening requires no additional training and is appropriate for licensed health care practitioners across a variety of fields1.
Scoring Each Item is scored as 1 or 0. A score >5 suggests depression; any score over 5 should have a follow up. A score >10 is almost always an indication of depression. A “Yes” on questions 2,3,4,6,8,9,10,12,14,15 is considered a positive indicator and scored as 1. A “No” on questions 1,5,7,11, 13 is scored as 1 and considered a positive risk factor for depression.
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO
Populations Specifics This scale was designed to be implemented in older adults who are healthy, medically ill and those with mild cognitive impairment. It can be effectively used as a screening device in the community, acute setting and long-term care facilities. Additionally there is some research that indicates the questions concerning behavioral inactivity may be indicative of post operative depression and delirium5.
Evidence for use of the short version Current literature suggests that the GDS:SF is able to accurately predict a diagnosis of depression 5. The Short Form when compared to the original Long Form demonstrated a strong positive correlation for accurate screening for depression. Additionally the GDS:SF is recommended for its brevity, compared to the original, in acute settings4. Suggestions
Clinicians must remember this is only a screen for the risk of developing depression, not a diagnostic tool.
A referral to providers with advanced training in depression management should be considered for anyone with a score >5.
As PTs the behavioral inactivity questions can easily be intervened upon using group therapies, and referrals for recreational therapy.
An interdisciplinary approach to implementing this screening should be employed.
The APTA Geriatric Section has links to continuing education that may be beneficial in addition to providing access to forums with experts in the field: http://geriatricspt.org/index.cfm
References:
1. Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In T.L. Brink (Ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165-173). NY: The Haworth Press, Inc.
2. Blazer, D.G. (2009). Depression in late life: Review and commentary. FOCUS, 7(1), 118-136
3. Greenberg, Sherry A. "Geriatric Depression Scale (GDS)."Practical Guide to the Care of the Geriatric Patient (2007): 646-47. Try This:. Hartford Institute for Geriatric Nursing, Nov. 2012. Web. https://consultgeri.org/try-this/general-assessment/issue-4.pdf
4. Diagnostic validity and added value of the geriatric depression scale for depression in primary care: A meta-analysis of GDS30 and GDS15 Mitchell, Alex J. et al. Journal of Affective Disorders , Volume 125 , Issue 1 , 10 – 17
5. Allen, Jacqui, and Merilyn Annells. "A Literature Review of the Application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist to Community Nursing Cohorts."Journal of Clinical Nursing 18.7 (2009): 949-59. Wiley Online Library. Web. 3 July 2016. http://www.ncbi.nlm.nih.gov/pubmed/19284431
6. Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening cale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
The Geriatric Depression Scale: Short Form is designed to identify older adults who may be at risk for becoming depressed1. Depression is prevalent in 8-16% of community dwelling older adults and even more common among those in long term care facilities2 (Blazer, 2009). Depression is often overlooked in older adults or simply attributed to other issues associated with aging. Depression is not a normal part of aging and should be screened for by all healthcare professionals. Signs of depression in senior citizens may include but are not limited to feeling tired, empty, altered appetite, unexplained pain, loss of interest in activities, altered sleep cycles, anxiousness and irritability1. As PTs we will consistently have direct contact with older adults in long term care facilities on a more regular basis than many other professionals. The application of the GDS:SF is simple, quick and can have a dramatic impact if it is appropriately implemented and followed up.
Learning Objectives:
1) Understand the basis for using the Geriatric Depression Scale Short Form
2) Learn to implement and score the GDS-SF.
3) Determine appropriate and inappropriate populations for using the GDS-SF.
4) Understand what to do with the results of the screening
Basics of the scale
Geriatric Depression Scale: Short Form
The short version of the Geriatric Depression Scale is a 15 question measure of depression risk in senior citizens. Items are simple yes/no questions that can be filled out with the patient in under 10 minutes 3. The questions that comprise the short form were selected from the original 30 item GDS based upon their validity and correlation with a diagnosis of depression4. Application of the screening requires no additional training and is appropriate for licensed health care practitioners across a variety of fields1.
Scoring
Each Item is scored as 1 or 0.
A score >5 suggests depression; any score over 5 should have a follow up.
A score >10 is almost always an indication of depression.
A “Yes” on questions 2,3,4,6,8,9,10,12,14,15 is considered a positive indicator and scored as 1.
A “No” on questions 1,5,7,11, 13 is scored as 1 and considered a positive risk factor for depression.
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO
Populations Specifics
This scale was designed to be implemented in older adults who are healthy, medically ill and those with mild cognitive impairment. It can be effectively used as a screening device in the community, acute setting and long-term care facilities. Additionally there is some research that indicates the questions concerning behavioral inactivity may be indicative of post operative depression and delirium5.
Evidence for use of the short version
Current literature suggests that the GDS:SF is able to accurately predict a diagnosis of depression 5. The Short Form when compared to the original Long Form demonstrated a strong positive correlation for accurate screening for depression. Additionally the GDS:SF is recommended for its brevity, compared to the original, in acute settings4.
Suggestions
Additional Resources
References: